A Multicenter Consortium to Define the Epidemiology and Outcomes of Inpatient Respiratory Viral Infections in Pediatric Hematopoietic Stem Cell Transplant Recipients

Fisher, Brian T.; Danziger‐Isakov, Lara; Sweet, Leigh R.; Muñoz, Flor M.; Maron, Gabriela; Tuomanen, Elaine; Murray, Alistair; Englund, Janet A.; Dulek, Daniel E.; Halasa, Natasha; Green, Michael; Michaels, Marian G.; Madan, Rebecca Pellett; Herold, Betsy C.; Steinbach, William J.

doi:10.1093/jpids/pix051

Cited by 64 publications

(75 citation statements)

References 16 publications

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“…In allogeneic HCT, HRVs are the most frequently diagnosed entities among children according to a large retrospective multicenter study, contributing 162 (62%) of 259 CARV events in the first year posttransplant (74). A quarter of these children had a diagnosis of lower RTID at onset and approximately one-half required some form of respiratory support, but ICU admission remained rare, 6 of 162 (4%).…”

Section: Other Carvs In Sot and Allogeneic Hctmentioning

confidence: 99%

Community-Acquired Respiratory Viruses in Transplant Patients: Diversity, Impact, Unmet Clinical Needs

2019

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SUMMARY Patients undergoing solid-organ transplantation (SOT) or allogeneic hematopoietic cell transplantation (HCT) are at increased risk for infectious complications. Community-acquired respiratory viruses (CARVs) pose a particular challenge due to the frequent exposure pre-, peri-, and posttransplantation. Although influenza A and B viruses have a top priority regarding prevention and treatment, recent molecular diagnostic tests detecting an array of other CARVs in real time have dramatically expanded our knowledge about the epidemiology, diversity, and impact of CARV infections in the general population and in allogeneic HCT and SOT patients. These data have demonstrated that non-influenza CARVs independently contribute to morbidity and mortality of transplant patients. However, effective vaccination and antiviral treatment is only emerging for non-influenza CARVs, placing emphasis on infection control and supportive measures. Here, we review the current knowledge about CARVs in SOT and allogeneic HCT patients to better define the magnitude of this unmet clinical need and to discuss some of the lessons learned from human influenza virus, respiratory syncytial virus, parainfluenzavirus, rhinovirus, coronavirus, adenovirus, and bocavirus regarding diagnosis, prevention, and treatment.

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Section: Other Carvs In Sot and Allogeneic Hctmentioning

confidence: 99%

Community-Acquired Respiratory Viruses in Transplant Patients: Diversity, Impact, Unmet Clinical Needs

2019

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“…HCoV has been described as a possible etiology of severe pneumonia in immunocompromised hosts [64][65][66][67]. Data are limited for this high-risk population and particularly are lacking in pediatric hematopoietic cell transplantation (HCT) recipients [68]. Among 404 children aged <18 years who underwent allogeneic HCT from April 2008 to September 2018 at Seattle Children's Hospital, HCoVs were the third most common respiratory viruses detected post-HCT following rhinovirus and parainfluenza virus (preliminary data).…”

Section: Immunocompromised Hostmentioning

confidence: 99%

What’s New With the Old Coronaviruses?

Ogimi

Kim

Martin

et al. 2020

Journal of the Pediatric Infectious Diseases Society

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Coronaviruses contribute to the burden of respiratory diseases in children, frequently manifesting in upper respiratory symptoms considered to be part of the "common cold. " Recent epidemics of novel coronaviruses recognized in the 21st century have highlighted issues of zoonotic origins of transmissible respiratory viruses and potential transmission, disease, and mortality related to these viruses. In this review, we discuss what is known about the virology, epidemiology, and disease associated with pediatric infection with the common community-acquired human coronaviruses, including species 229E, OC43, NL63, and HKU1, and the coronaviruses responsible for past world-wide epidemics due to severe acute respiratory syndrome and Middle East respiratory syndrome coronavirus.

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“…Risk factors for increased mortality include LRTI, mismatched allogeneic HCT, infection in the pre-engraftment phase (eg, health care-associated infection during the index transplant hospitalization), high-dose steroids at time of LRTI infection, oxygen requirement, and mechanical ventilation. 4,[53][54][55] Mortality has been demonstrated to be particularly high for RVI outbreaks in the health care setting, likely a consequence of the high-risk nature of this patient segment and perhaps due to delays in diagnosis in this setting. 54,56,57 Detection of RVI in the immediate pretransplant period is associated with both LRTI and with decreased survival at 100 days, with mortality greatest in symptomatic patients.…”

Section: Complications and Outcomesmentioning

confidence: 99%

Respiratory Virus Infections of the Stem Cell Transplant Recipient and the Hematologic Malignancy Patient

Fontana

Strasfeld

2019

Infectious Disease Clinics of North America

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Respiratory virus infections (RVIs) are increasingly recognized as a cause of significant morbidity and mortality in recipients of hematologic stem cell transplant (HCT) and patients with hematologic malignancy (HM). 1,2 With now widespread use of molecular diagnostics, the epidemiology and spectrum of clinical disease of these infections can be better characterized. Apart from influenza, the currently available antivirals are limited in efficacy and/or associated with potential for toxicity, thus emphasizing the importance of prevention strategies. This article provides a review of the epidemiology, clinical characteristics, management, and prevention of RVIs in HCT recipients and HM patients.No disclosures. KEYWORDS Respiratory virus infection Hematopoietic stem cell transplant RSV Influenza Parainfluenza Human metapneumovirus Rhinovirus Coronavirus KEY POINTSThe morbidity and associated complications of respiratory virus infections are greater in hematopoietic stem cell transplant recipients and patients with hematologic malignancy than in immunocompetent individuals, with severity of illness related to the degree of immunosuppression. Molecular microbiologic testing is the gold standard for diagnosis, allowing differentiation of what are largely overlapping clinical syndromes. Most of the respiratory viruses, apart from influenza and in some circumstances respiratory syncytial virus and adenovirus, are managed supportively. Prevention is key and should focus on vaccination for influenza, avoidance of ill contacts, and compliance with principles of infection control.Infect Dis Clin N Am 33 (2019) 523-544 a Studies are a combination of PCR and traditional laboratory methods (eg, culture, direct fluorescent antibody, and enzyme immunoassay). b PCR-based studies. c Includes all-cause and attributable mortality with variable timeframe to death. d One mortality in a coinfected patient attributed to enterovirus/rhinovirus infection.

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A Multicenter Consortium to Define the Epidemiology and Outcomes of Inpatient Respiratory Viral Infections in Pediatric Hematopoietic Stem Cell Transplant Recipients

Abstract: Results of this multicenter cohort study suggest that H-RVIs are relatively common in pediatric HSCT recipients and contribute to significant morbidity and death. These data should help inform interventional studies specific to each viral pathogen.

Cited by 64 publications

References 16 publications

Community-Acquired Respiratory Viruses in Transplant Patients: Diversity, Impact, Unmet Clinical Needs

Community-Acquired Respiratory Viruses in Transplant Patients: Diversity, Impact, Unmet Clinical Needs

What’s New With the Old Coronaviruses?

Respiratory Virus Infections of the Stem Cell Transplant Recipient and the Hematologic Malignancy Patient

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